Redesigning Healthcare (Book Review)

If there is a “right” person to think about how to design the future of healthcare, it’s probably Peter Jones, associate professor at OCAD University in Toronto, Canada. I found his book by turns insightful, inspiring, and intimidating, though his attitude is always optimistic and his tone educational. It’s always about improving patients’ experiences, with plenty of case studies and tips on how to follow the design process. In fact, this book could be used as a text, and I personally would love to be able to take that course.

The book covers three huge areas of thinking:

Rethinking Care. Until now, patients have often been passive, and healthcare professionals have been thinking about health case by case. Worse, the healthcare system itself is “glued together”—as anyone can attest who has tried to navigate from a generalist to a selection of appropriate specialists, deal with insurance and one or more hospitals sending conflicting bills, or assist an elderly family member with managing multiple conditions through the maze of regular care, hospitalization, long-term care, and, eventually, hospice. The whole situation creates an opportunity for design thinking to be applied to multiple challenging problems. Luckily, this is where design thinking excels.

Rethinking Patients. Patients need to become active agents and decision makers about their own care. In short, when we are ailing, we need to become “Health Seekers” who consult “Dr. Google” before consulting a medical professional. Of course, to make good decisions most of us need additional training and tools to sort through and process the volume of information that we will find. To work with these retooled Health Seekers, the medical profession needs to understand the new paradigms, as do those who work with medical billings, and even those who will conduct the design research that will help us get to a solution.

Rethinking Care Systems. I never realized that many aspects of hospital design have not changed in over 100 years. If you have been in a new hospital recently, however, you may have noticed that there are surprising changes—in more than just the medical equipment being used. Buildings and visiting policies are friendlier to patients and families, and physicians and caregivers are getting more and better education in how to work with empowered patients. This is a good start, but there is more to do—just ask any of us who have recently visited an emergency room.

Jones also advocates for systemic design in what he calls “Healthy IT.” This is especially important as we deal with the challenges of Electronic Medical Records, a patchwork of computer systems, increasing patient volume, and decreasing available funds.

I found the final chapter most inspiring and a little intimidating. Jones writes about the potential for improved healthcare through three lenses:

What can be accomplished in the near term? Can we get ourselves from the big box hospital model to community health centers? Designers working on these problems report a variety of issues to overcome, including structural and organizational issues. Organizations are not currently making solid use of design techniques, but there is some promising research being done by cross-functional teams in hospitals.

What are the critical healthcare problems that must be resolved in the mid-future? A recent investigation by a graduate class at OCAD identified several critical problems, ending with a “Whole Care Triage Funnel.” Following processes like these, we can identify the right problems to work on first, and understand their impact on related and secondary problems.

What does the longer-term forecast look like? Jones defines longer-term here as ten to twenty years or more. And he explains ways to structure the questions, rather than answers them in the book.

It’s been clear for some time that our healthcare systems themselves need care. We need to bring coherence and economies to a fragmented network with many types of practitioners and organizations. We need to help practitioners and empowered patients find their way through a huge influx of devices, medications, and confusing information. We need to use design thinking to apply lessons learned across the globe—and we will need some of the best design minds to get this done.